We recently had a delegation from an American aid organisation visit our clinic. I didn't stick around for the circus because preceding the visit a list of demands was given to the clinical manager. Now this organisation isn't even one of our major sponsors - from what I understand the money they've given us was just enough to put up some shelves in our pharmacy. Don't get me wrong, we're grateful for any donations, but if you're going to give money for a worthy cause, you should do it out of the goodness of your heart, not so you can make them jump through hoops for you.
Now, my boss was hoping that after their visit they'd donate a lot more money to us so she complied with their demands. This made me realise that I could never run an NGO because there's no way I'd cater to petty whims.
Anyway, so the first thing they wanted was 16 plaques emblazoned with their emblem to be put up around the clinic. Who knows why they wanted so many, but being a very small clinic, this basically meant that a plaque had to be put up on every bare surface. So when I stood in the passage where the patients sit and wait to be seen I could see no less than 8 of their plaques from one spot. It was ridiculous. Talk about hard sell. Maybe they think African people are just really slow on the uptake.
The next demand was that all doors should be open so that they can walk through the clinic and see into every room. They re-emphasised that no doors should be closed. I thought it was absolutely absurd to ask such a thing. How is anyone supposed to see patients with the doors open? Oh, that's right, we mustn't see patients - we're supposed to stop everything for them because they're so important. My question was do we also leave the sluice room, cupboard and toilet doors open? They did say NO closed doors...
Next thing was that they also wanted to know how we were managing TB, so they wanted to see all our TB facilities like the x-ray room and treatment room, but they specified that there should be no TB patients present. What a laugh. The kind hearted Americans coming to Africa to help poor sick Africans, as long as they don't actually have to come into contact with poor sick Africans! I was wondering where we were going to hide them. Maybe they heard that riddle about hiding an elephant in custard and think that we must be pretty damn good at hiding things! Actually, we are :) (But that's not the point.)
They sent forward their itinerary which was also fairly ridiculous with things like "park in parking lot" and "medical director comes to car to greet us" and at a stage I think somebody was supposed to jump on one leg with one hand on their head and the other on their nose or something. They also had specified times for everything. They obviously haven't realised that there is no time keeping in Africa. Especially Mpumalanga. But I can't really hold that against them.
Then, of course, there was the obligatory demand for bottled water.
I think it's great that 1st world countries are trying to help us out, especially since our own government doesn't give a rat's ass, but I really think that that doesn't entitle them to treat us like plebs and make us fall all over them and grovel at their feet. Because then I wonder what their real motivation is. It feels too much like "look at me, I'm a wonderful person, look how I'm helping these poor people, this is how you spell my name..."
About Me
- amanzimtoti
- Mpumalanga, South Africa
- I'm a doctor and a mother. When i'm not practising medicine, I'm taking care of the kids: a little boy, a little girl and their slightly less mature father.
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16 comments:
Growing up in Africa, it always amazed me how 'divorced' the aid organizations were (especially the big ones) from the actual problems and issues on the ground. IMO, their giving seemed more about them than about the individuals they were trying to "help."
Thanks for a great post, you captured the surreal nature of the encounter very well.
Why thank-you beach bum!
Shocking post and I am just amazed that any "charitable" organization would behave in such a thoughtless manner. As if it isn't hard enough to care for patients in a clinic without dealing with those morons!
This is a great example of everything wrong with this kind of aid. I actually have a list of things I don't believe in on my blog, and volunteer doctors are one of them.
That's just sad...the NGO can give you the $ they spent on the plaque and trip to treat patients and stay home next time.
What a sad story.
You put it so succinctly that I can only sit here, mouth agape, and try to fathom what happened.
If an NGO wants to donate money, then they should donate money, supplies, etc.
No one should be made to "perform" for them.
So maybe the aid organizations should just send the money and never visit?
If you chose to spend the money on shelves instead of antibiotics, maybe you do need checking up on. There is so much fraud and waste going on, its appalling that you would think there should be no follow up.
signed, an ugly American. Your welcome.
anonymous, what would you put the antibiotics on. one also needs examination rooms to examine patients in or is that also a waste of money?
maybe you don't know the relative cost of medication (antiretrovirals rather than antibiotics actually) as compared to shelves.
also, i assume you meant you're rather than your???
Thanks for that post amazimtoti!
Good grief...people with TB in a clinic? What is the world coming to.....:-)
I agree with beach bum about it being surreal, but sadly I have seen this as well, outside of Africa.
Anonymous, I'm not saying there should be no follow up - of course there should be follow up! There's alot of corruption out there, especially in Africa. What I am saying is that donating money does not automatically make you better or more important than everyone else and give you the right to expect extraordinarily special treatment. If I donated money to a clinic, I would also want to visit it to see what goes on there, but I wouldn't expect everything to stop for me or people to bow down before me.
As for the shelves, thank-you bongi, you pretty much covered what I wanted to say in response to that.
Anonymous - get real. She never said there should be no follow-up, just that the people who are doing the follow up should at least pretend to care more about the patients and the work they're doing than themselves and their image. On the whole, I don't think Americans are very ugly but you made yourself sound hideous there. Pity you didn't have the decency to leave your name along with your stupid statement.
Amanzimtoti: Thanks for sharing this post. I know you're not able to identify the supporting organization. I just wish we knew, so us less ugly Americans would know which organization(s) we shouldn't support,as well as expose them for their arrogance and avarice.
Anonymous: You really drive home the point of showing how ugly, cowardly, and illiterate Americans can be.
That is so discouraging. I work in corporate America now, but will be going back to med school in the next two years to get away from such crap. Looks like it will follow me into medicine, as well at times. The world is filled with selfish, stupid people.
"List of Demands" AKA Itinerary for the available time and what they hoped to accomplish and wanted to see and evaluate. Scratching my head over the 16 plaques, maybe so every photo had their logo - for marketing purposes back home? No doors closed means "we want to see everything", in this day and age complete transparency is the requirement. An opportunity to examine TB tx facilities without patients present seems appropriate, does the clinic really want to discuss the inadequacies of their facility/supplies in front of patients? Or perhaps they have heard you are "good at hiding things". Ensuring space for vehicles of a visiting group doesn't seem extraordinary, nor does the expectation that the medical director be made available for the visit and requested to lead the visiting group from the start. There are usually photo ops taken, these are used to publicize the very existance of these clinics and their significant needs. The reminder that the visitors do not have the same tolerance for the local pathogens that the native people might have and a request for bottled water is also not particularly egregious.It does seem funny to specify every action and a timetable, putting these things down so concretely in writing you risk people interpreting your intentions with their biases unchallenged. If the organizer had communicated directly to the clinic relating the very same information along with the why's and wherefor's perhaps they wouldn't have been perceived as self serving idiots. Visiting NGO's understand that the limited time spent at a clinic such as this one is for the express purpose of understanding the needs of the local patients and their clinic. The physicians who volunteer their time understand that the few patients they treat are a relative sample of the local needs of the patient population. They know full well that the days effort is a drop in the bucket, I hope the clinic understood to present to them the patients that would be an appropriate representation of the community's needs. These complaints seem to stem from very obvious frustration and anger, but it seems misdirected. I hope the clinic director was more cognizant of what was transpiring and utilized the opportunity "circus" to its fullest.
Chris c, as I said in the beginning, this company did not then, not has it up to now contributed any significant amounts of money to the clinic. If they had, maybe that would justify their behaviour, but they didn't. They made a single very small contribution and that was it and they then used that as an excuse to promote themselves. I think you're spot on about the photo ops because that was their main objective and they will not be using those photos to promote our clinic, I can tell you that. Bearing in mind that the money they contributed was less than what's needed to pay for a full course of TB treatment for ONE patient, to expect us to close down treatment facilities for TB patients for one day would in fact have been detrimental to those patients. I reiterate that they still have not contributed any other money to the clinic and I doubt they have any intention to. Also, an appropriate representation of patients could not be presented to them because they did not want to see any.
The company who is our major sponsor does visits and check-ups at our clinic all the time, but there is no drama with them. Having them visit is an absolute pleasure. And they truly care.
Dear Amanzimtoti, I was picturing a group like Doctors without borders or some such! Instead it sounds more like a scam group were the donations they raise go 90% to their overhead! You would be doing everyone a huge favor by allowing more access to who they are, perhaps directing us to their website? I am formally requesting a list of your sponsers so that I may give a donation, thank you, Chris C.
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